Dermatology Coding Alert

Question: How should I code for a 0.05-cc injection of Kenalog into an acne cyst? The HCPCS code only mentions milligrams.

Missouri Subscriber

Answer: You need more information. Ask the dermatologist who did the injection how many milligrams he used. Cubic centimeters (cc) are a measure of volume, and milligrams (mg) are a measure of weight.
 
There's no consistent way to convert cubic centimeters to milligrams. One drug might have 30 mg per 1 cc; another might have 50 mg per 1 cc.
 
Once you find out how many milligrams were in the injection, report one unit of HCPCS code J3301 (Injection, triamcinolone acetonide, per 10 mg) for each 10 mg.
 
Report the injection with 11900 (Injection, intra-lesional; up to and including seven lesions). This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide (Kenalog), for large nodules. Insurers may cover the treatment with an acne diagnosis (706.1, Diseases of sebaceous glands; other acne) if the injection is medically necessary.